Bill Richardson on Health Care

Democratic Governor (NM); Secretary of Commerce-Designee

FactCheck: Between 7% and 31% of costs are administrative

Richardson used a questionable figure on health care costs, saying that “one-third” of the $2.2 trillion spent on health care “goes to administration and bureaucracy.” The Centers for Medicare and Medicaid Services does project that health care spending
in the US will be more than $2.2 trillion in 2007. But the figure for administrative spending is only 7.4% of all national health expenditures in 2007: for “program administration and net cost of private health insurance.”

Richardson’s statistic does
have some support, however. A 2007 survey conducted by PNC Financial Services Group said that nearly a third of expenditures went to administration. But that finding was merely the opinion of the 200 hospital and insurance company executives queried.

Also, a 2003 article in the New England Journal of Medicine said that in 1999, 31% of health care expenditures went to administration. The authors included indirect costs, such as an estimate for the time physicians spend on administrative work.

Universal health care is a right for every American

I believe universal health care is a right for every American. 1/3 of all of our healthcare budget, $2.2 trillion, goes to administration and bureaucracy, failure to have electronic records. That has to shift to direct care. Prevention is going to be the
key. 33% of Medicare costs are, today, related to diabetes. We’ve got to have an elimination of junk food in schools. We have to be a country that does more research on stem cell research, on autism, on heart disease, on chronic diseases, on cancer.

Source: 2007 Des Moines Register Democratic Debate
Dec 13, 2007

Give students incentives to become health professionals

In exchange for two years of tuition paid by the government or loans, you give one year of national service to the country. This will attract more doctors and will enable students to afford a college education when it’s taking them seven years to pay for
this. Get rid of the student loan and bank agencies that are ripping off the system. Re-establish, on a general basis, the doctor-patient relationship. Deal with Medicare reimbursement and ways that we also not forget health professionals.

Source: 2007 Democratic debate at Drexel University
Oct 30, 2007

Universal health care, no matter who you are

Q: Do you favor universal coverage without exception, and how would you pay for it?

A: I do favor universal health care, no matter who you are, rich or poor, black, brown, white, that has to be the fundamental point in my health-care plan. I believe th
way you do it is by:

Having no new bureaucracies

Giving choice to everybody to keep the health-care plan, if they have it

But I would first focus on the fact that we spend $2.2 trillion on health care, yet 31% of that goes to administration
bureaucracy and lack of electronic records.

Where I differ with other candidates, especially Sen. Edwards, is I don’t propose a new tax or any new bureaucracy.

We need to focus more on prevention, on getting rid of junk food in schools, cancer
research.

I would allow everybody to participate in the congressional plan.

I’d lower Medicare to 55. It’s today 65 and over.

I would have a shared responsibility. Everybody participates, especially employers, in my health-care plan.

Cover undocumented workers under health plan

Q: Does your health care plan cover undocumented workers?

A: Yes, it would. It should cover everybody. In this country, no matter who you are, whether you’re a ditch-digger, you’re a teacher, you’re a
CEO, you’re a waiter, you’re a maid, every American deserves the right to the best possible quality health care. That would be part of my plan.

FactCheck: Correct that 33% of Medicare is diabetes

Richardson asserted, “Medicare: 33% of it is diabetes.” That surprisingly high figure turns out to be reasonably accurate. The Center for Medicare & Medicaid Services said, “about 18% of Medicare beneficiaries have diabetes, yet they account for
32% of Medicare spending.” To be strictly accurate Richardson should have said that diabetics account for the large share of Medicare spending, not diabetes. The disease is usually accompanied by a variety of other ailments that also require treatment.

Fund fight on HIV/AIDS both nationally and internationally

Q: African-Americans, though 17% of all American teenagers, are 69% of the population of teenagers diagnosed with HIV/AIDS. What is the plan to stop and to protect these young people from this scourge?

A: It is a moral imperative that
America have a policy to fight this dreaded disease both nationally and internationally. You got to make some tough choices. First, we’ve got to have needles [in exchange programs]. We have to be sure that we have efforts in the
African-American community to have comprehensive education. In addition, we have to deal with Africa. Close to 20% of the African people have some kind of HIV virus. It’s important that the president of the US make a major funding effort, a major
commitment to deal with this issue. And here I’m going to say something positive about President Bush. His funding for Millennium accountability and Millennium appropriations has been relatively impressive.

NM plan: mandatory; prevention-based; choose your own plan

We insured every child under five in New Mexico and increased immunizations. We got rid of junk food in schools. We brought mandatory phys ed in. My plan is mandatory. You do have everybody sharing -- the employer, the employee, you have the state and
the federal government. If you were satisfied with your health care plan, you can keep it. No new bureaucracy. But you focus on prevention. You allow everybody to get the Congressional plan that every member here has. You bring Medicare 55 and over.

Source: 2007 Dem. debate at Saint Anselm College
Jun 3, 2007

Focus on preventive healthcare without raising taxes

Q: You are perhaps the most strident on the position against raising taxes to pay for health care.

A: As Democrats, I just hope that we always don’t think of new taxes to pay for programs. This is what I would do. I would have the following principles
In my new health care plan, no new bureaucracy. Every American shares, along with businesses, the state and the federal government. I would focus on prevention. I would also ensure that the first thing we do is deal with the bureaucracy & inefficiencies
in our health care system. 31% of our health care goes to inefficiencies and bureaucracy. If we had a health information system where doctors and nurses could share information about health care, we would save billions of dollars. I would also make sure
that we would re-establish the doctor- patient relationship, eliminate those in the middle, like HMOs and others. But my plan would focus on prevention, and focus more on deterring diseases like diabetes, that is 30% of our Medicare costs.

All Americans need same coverage as members of Congress

We, as Americans, are in crisis today. As a governor I have to deal with the health care crisis every day. So what would I do as a president?

All Americans and all businesses should have the same coverage as members of Congress.

Americans
55 and older should be able to purchase coverage through Medicare. Today it’s at 65.

A trade: the federal government, Medicare, goes to treat seniors and the disabled in exchange for the state dealing and increasing Medicare coverage for children and
families.

Veterans: We should give our military veterans the access they need anywhere they want, any time they want.

What about costs? I would have a cooperative plan between the employer, businesses, the state and the federal government.
I would propose a refundable tax credit for those Americans that need coverage based on income. I would clamp down on credit card companies that are covering excessive interest rate costs.

State flexibility creates universal coverage without taxes

A: I would not increase taxes. The problem is the excessive costs of health care and the coverage.
I would focus on preventive health care: like child obesity programs. But the big problem is the huge administrative costs of health care. 31% of the costs are administrative. A lot of it is waste. There are 50 Medicaid programs.
They don’t give the states the flexibility to run them.

What I like is what some states have done, and that is a Massachusetts-style plan with good benefits that basically says we facilitate it for employers and employees to get mandatory coverage.

Shift Medicaid costs back from states to federal

We governors depend heavily on our states’ relationship with Washington. The relationship with Washington ought to be a partnership based on consultation and a shared interest in the common good.

Washington views the states cynically as a safety valve
for its own chronic inability to manage our affairs. It’s the worst of all possible worlds: Washington sets the terms of what must be done in certain public programs, then shifts the financial burden to the states.

The worst case in point is Medicaid.
Costs are rising , yet the federal government keeps reducing its share of the funding for the program. In my new NM budget, despite federal cuts, we increased Medicaid spending by 16%. Faced with rising costs, we remained committed to providing health
care to our most vulnerable citizens. We implemented cost containment measures, and these are a viable solution in the short term, but they won’t work in the long term if the feds continue to increase the states’ share of the costs.

Secure lower prescription drug costs for seniors

We passed legislation to secure lower prescription drug costs for seniors and funded efforts to recruit and reform health professionals. Shoddy contracts and poor financial management by the previous administration have lost the state tens of millions
of dollars in matching federal funds. We’re working through the mess and have put real systems of accountability in place as we provide health care services to hundreds of thousands of New Mexicans.

Source: 2004 State of the State speech to the New Mexico Legislature
Jan 20, 2004

Focus on raising childhood immunization rates

While we’re facing an explosion of Medicaid costs that are straining our budget, I pledge to protect Medicaid eligibility levels for children. I’m proposing to increase Medicaid by providing approximately $55 million in new state funds to match
federal funds. I want to also continue our focus on raising childhood immunization rates in New Mexico. Immunizing more of our children today means we’ll have healthier, more successful citizens down the road.

Source: 2004 State of the State speech to the New Mexico Legislature
Jan 20, 2004

Increase access to affordable health care

I have two defining goals in health-care reform: decrease the number of uninsured New Mexicans - and increase access to affordable health care for all. Health care is a shared responsibility of governments, employers and individuals and their families.
It will not be quick and it will not be easy, but we must have the best efforts of everybody involved in health care - from consumers to HMO executives - if we are to find ways to attain my goals of wider coverage and greater access.

Source: 2004 State of the State speech to the New Mexico Legislature
Jan 20, 2004

Consolidate mental health and substance abuse therapy needs

I want to create a new way to consolidate mental health and substance abuse into a single comprehensive advisory structure. I want to immediately create a common plan and structure to address the mental health and substance abuse therapy needs
of New Mexicans, and have a draft ready to review by March, a request for proposals out by September, and the system up and running by July of 2005.

Source: 2004 State of the State speech to the New Mexico Legislature
Jan 20, 2004

Restrain Medicaid costs and maintain benefits

We’re working diligently to uncover and eliminate fraud, abuse, and errors in the Medicaid system. If we don’t control Medicaid costs now, we will face cutting eligibility and services down the road. We have to pay for these programs, and this is the
most fiscally responsible way to do it. I say we restrain costs and maintain benefits now, while working to create more access in the long run for working New Mexicans through my healthcare purchasing collaborative.

Source: 2004 State of the State speech to the New Mexico Legislature
Jan 20, 2004

Affordable access to healthcare for all New Mexicans

A robust economy with successful companies translates into higher levels of healthcare and coverage for all. However, in the short term, we can make some fundamental changes to how we approach healthcare in New Mexico and improve the results.
We need to find a way to make healthcare more affordable and ensure that all New Mexicans have the access to the care that they need.

My approach requires innovation, proven solutions, and use of best practices
to shift New Mexico from fragmented care delivery to purchasing organized and accountable systems of care. It combines good ideas from other states, with increased efficiency and preventative healthcare.

During this campaign I have already made specific proposals regarding the recruitment and retention of doctors and nurses. And I have proposed a prescription drug program for our seniors.

New Mexico Cares: invest in our health

[My healthcare plan is] driven by a principle that says the health of our citizens is something as a state where we must invest-or we risk falling farther behind in jobs, in education, and every other major category. My approach, which I call “New
Mexico Cares,” is a seven-part plan.

Immediately re-evaluate the structure of our Medicaid contracts and programs to ensure we are holding providers accountable for superior treatment and improved results.

Keep doctors in New Mexico by lowering
taxes.

Institute a new approach of comprehensive care for our elderly and chronically ill.

Expand Medicaid enrollment for children.

Create a consumer report card for hospitals and healthcare providers.

Offer a partnership to business that
gives a tax break in exchange for a commitment to provide health insurance to fulltime employees.

Establish a statewide telemedicine network, to provide advanced levels of diagnosis and treatment to rural communities throughout our state.